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18.10.2017 | Miscellaneous | Ausgabe 12/2017

Graefe's Archive for Clinical and Experimental Ophthalmology 12/2017

Evaluation of a visual acuity test using closed Landolt-Cs to determine malingering

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 12/2017
Autoren:
Nils Kröger, Clemens Jürgens, Thomas Kohlmann, Frank Tost

Abstract

Purpose

To evaluate a visual acuity test (VAT) with unexpected optotypes to detect malingering.

Methods

We tested two groups. Group 1 consisted of 20 individuals with normal best corrected visual acuity (BCVA). Group 2 included participants with ocular diseases and reduced BCVA. All subjects underwent a VAT proposed by Gräf and Roesen to assess suspected malingering. This test used 36 charts with one Landolt-C per page. The first 20 optotypes were Landolt-Cs, while at positions 21, 26, 30, and 34 closed rings were presented. The testing distance was adapted to 50% of the test person’s visual acuity. The test person was requested to name the gap direction of the Landolt-C within 3 s. The complete testing conversation was recorded digitally to determine response latency for each optotype from the audio tracks.

Results

The average response time was 0.46 s in group 1 and 0.45 s in group 2 for the first 20 Landolt-Cs. In both groups the response time was significantly extended (p < 0.05) for the first closed ring compared to the mean of the first 20 Landolt-Cs, (group 1: 2.9 s; group 2: 2.3 s). The following three closed rings had also longer response times. However, these differences were not significant.

Conclusions

Our results suggest that the proposed test may be helpful to evaluate ocular malingering. The testing procedure appeared to be feasible and showed good repeatability. The fast training effect may be a limitation for malingering detection.

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